建康道按察副使奥屯周卿子。年二十有三。至元戊寅三月间病发热。肌肉消瘦。四肢困倦。嗜
卧盗汗。大便溏多。肠鸣不思饮食。舌不知味。懒言语。时来时去。约半载余。请予治之。诊其脉
浮数。按之无力。正应王叔和浮脉歌云。脏中积冷荣中热。欲得生精要补虚。先灸中脘。乃胃之经也
。使引清气上行。肥腠理。又灸
气海。乃生发元气。滋荣百脉。长养肌肉。又灸三里。为胃之合穴、亦助胃气。撤上热。使下于阴
分。以甘寒之剂泻热。其佐以甘温。养其中气。又食粳米羊肉之类。固其胃气。戒于慎言语。节饮
食。惩忿窒欲。病气日减。数月。气得平复。逮二年。肥盛倍常。或曰。世医治虚劳病。多用苦寒
之剂。君用甘寒之药。羊肉助发热。人皆忌之。令食羊肉粳米之类。请详析之。予曰。内经云。火位
之主。其泻以甘。藏气法时论云。心苦缓。急食酸以收之。以甘泻之。泻热补气。非甘寒不可。若
以苦寒以泻其土。使脾土愈虚。火邪愈盛又曰。形不足者温之以气。精不足者补之以味。劳者温之
。损者益之。十剂云。补可去弱。人参、羊肉之属是也。先师亦曰。人参能补气虚。羊肉能补血虚
。虚损之病。食羊肉之类。何不可之有。或者叹曰。洁古之学。有自来矣。
【凉膈散】治大人小儿积热烦躁。多渴。面热唇焦。咽燥舌肿。喉闭、目赤、鼻衄、领颊
结硬。口舌生疮。谵语狂妄。肠胃燥涩。便溺闭结。睡卧不安。一切风壅。皆治之。
连翘(四两) 朴硝(二两) 川大黄(二两) 薄荷
黄芩 山栀子 甘草(炙。各一两)
上七味为末。每服三钱。水一盏半。竹叶五七片。蜜少许。煎至七分。去渣。温服。食后。小
儿半钱。量岁数加减。得利下。止后服。
【龙脑鸡苏丸】治胸中郁热肺热。咳嗽吐血、鼻衄、血崩、下血、血淋。虚劳烦热。
柴胡(二两锉。同木通。以沸汤大半升浸一两宿。绞汁后。入膏) 木通(二两锉。同柴胡汁
)
阿胶 蒲黄 人参(各二两) 麦门冬(四两)
黄(一两) 鸡苏净叶(一斤。即龙脑薄荷) 甘草(一两半)
生干地黄末(六两。后膏)
上为细末。以蜜二斤。先炼一二沸。然后下生地黄末。不住手搅。时时入绞。下柴胡木通汁
。慢慢熬成膏。勿令焦。然后将其余药末同和为丸。如豌豆大。每服二十丸。熟水下。
【洗心散】治心肺积热风壅。上攻头目昏痛。肩背拘急。肢节烦疼。口苦唇焦。咽喉肿痛
。痰涎壅滞。涕唾稠粘。小便赤涩。大便秘滞。
白术(一两半) 麻黄 当归 荆芥
芍药 甘草 大黄(各六两)
上为细末。每服二钱。水一盏。入生姜、薄荷少许。同煎至七分。温服。
建康道按察副使奥屯周卿的儿子,二十三岁。在至元戊寅年三月期间生病,出现发热症状,肌肉消瘦,四肢困倦乏力,嗜睡且夜间盗汗,大便稀溏次数多,肠鸣音亢进,不想吃东西,舌头失去味觉,懒于说话,病情时好时坏,持续了半年多。请我诊治。诊察他的脉象浮而数,重按无力。这正应验了王叔和《浮脉歌》中的说法:“脏中积冷荣中热,欲得生精要补虚。”先灸中脘穴,这是胃的经脉所在,能使清气上升,充实腠理。又灸气海穴,以生发元气,滋养血脉,长养肌肉。再灸足三里穴,它是胃的合穴,也能助益胃气,撤除上部的热邪,使其下行进入阴分。使用甘寒性质的药剂来泻热,辅以甘温性质的药物,来养护其中的中气。同时食用粳米、羊肉等食物,以巩固胃气。告诫患者谨慎言语,节制饮食,克制愤怒,抑制欲望。病情日渐减轻,几个月后,正气得以平复恢复。等到两年后,身体肥胖强壮程度超过平常。有人问:世间的医生治疗虚劳病,多用苦寒性质的药剂,您却用甘寒的药物,羊肉会助长发热,人们都忌讳吃它,现在却让您吃羊肉、粳米之类的食物,请详细分析其中的道理。我说:《内经》说,对于火热之证作为主病,用甘味药来泻火。《藏气法时论》说,心气苦于涣散,急需用酸味药来收敛,用甘味药来泻之。要泻热补气,非甘寒不可。如果用苦寒药来泻脾土,会使脾土更加虚弱,火邪更加旺盛。又说,形体不足的,用气来温养;精气不足的,用味道来补益。劳损的病,用温法治疗;亏损的病,用益法治疗。《十剂》说,补法可以去弱,人参、羊肉这类就是补药。先师也说,人参能补气虚,羊肉能补血虚。虚损的疾病,吃羊肉之类,有什么不可以的呢?那人感叹说:洁古(张元素)的学问,是有来历的啊。
【凉膈散】治疗大人小孩积热烦躁,口渴多饮,面部发热嘴唇焦裂,咽喉干燥舌头肿胀,喉闭,眼睛发红,鼻出血,颈部脸颊结块坚硬,口舌生疮,胡言乱语狂妄,肠胃干燥涩滞,大小便闭塞不通,睡眠卧不安宁,一切风热壅盛之症,都能治疗。
连翘(四两) 朴硝(二两) 川大黄(二两) 薄荷
黄芩 山栀子 甘草(炙,各一两)
以上七味药研为细末,每次服用三钱,用水一盏半,竹叶五七片,少许蜂蜜,煎煮到七分满,去渣,温服,饭后服用。小儿服用半钱,根据年龄增减。如果得利下(腹泻),停止后续服药。
【龙脑鸡苏丸】治疗胸中郁热肺热,咳嗽吐血、鼻衄、血崩、下血、血淋,虚劳烦热。
柴胡(二两锉碎,同木通,用沸水大半升浸泡一个晚上,绞取汁液,之后加入膏方) 木通(二两锉碎,同柴胡汁一起)
阿胶 蒲黄 人参(各二两) 麦门冬(四两)
黄芪(一两) 鸡苏净叶(一斤,即龙脑薄荷) 甘草(一两半)
生干地黄末(六两,最后加入膏方)
以上药材研为细末,用蜂蜜二斤,先炼一二沸,然后加入生地黄末,不停地搅拌,不时加入绞好的柴胡木通汁,慢慢熬成膏,不要让锅焦糊。然后将剩余的药末混合做成丸子,如豌豆大小。每次服用二十丸,用熟开水送下。
【洗心散】治疗心肺积热风热壅盛,向上攻冲导致头目昏痛,肩背拘挛紧急,肢节烦疼,口苦唇焦,咽喉肿痛,痰涎壅滞,鼻涕唾液稠粘,小便赤涩,大便秘滞。
白术(一两半) 麻黄 当归 荆芥
芍药 甘草 大黄(各六两)
以上药材研为细末,每次服用二钱,用水一盏,加入生姜、薄荷少许,共同煎煮到七分满,温服。
The son of Aotun Zhouqing, Vice Commissioner of the Jiankang Circuit Surveillance Office, was twenty-three years old. In the third month of the Wuyin year of Zhiyuan, he fell ill with fever, emaciation, fatigue in the four limbs, somnolence with night sweats, loose and frequent stools, borborygmus, anorexia, loss of taste, reluctance to speak, and a fluctuating condition lasting for over half a year. I was invited to treat him. His pulse was floating and rapid, but weak upon deep pressure. This exactly corresponds to Wang Shuhe's "Song of Floating Pulse": "Cold accumulated in the zang organs, heat in the ying (nutritive) level; to generate essence, one must tonify deficiency." First, moxa was applied to Zhongwan (CV12), the front-mu point of the Stomach meridian, to guide clear qi upward and fatten the cou-li (skin and interstices). Then, moxa was applied to Qihai (CV6) to generate yuan qi (original qi), nourish the blood vessels, and grow muscles. Finally, moxa was applied to Zusanli (ST36), the he-sea point of the Stomach meridian, to assist stomach qi, withdraw upper heat, and direct it downward into the yin level. A sweet-cold formula was used to drain heat, assisted by sweet-warm herbs to nourish middle qi. The patient also consumed foods like japonica rice and mutton to consolidate stomach qi. He was advised to be cautious with speech, moderate diet, restrain anger, and curb desires. The disease gradually diminished, and within several months, his qi recovered. Two years later, his physique became twice as robust as before. Someone asked: "Physicians generally use bitter-cold herbs to treat consumptive diseases. Why do you use sweet-cold drugs? Mutton is believed to aid heat, which people usually avoid. Yet you prescribed mutton and japonica rice. Please analyze this in detail." I said: "The *Neijing* states: 'For fire as the primary pathogen, drain it with sweet flavor.' The *Lingshu·Zangqi Fashi Lun* states: 'The Heart suffers from flaccidity; hasten to use sour to astringe it, and use sweet to drain it.' To drain heat and tonify qi, sweet-cold is indispensable. If bitter-cold were used to drain spleen earth, the spleen would become more deficient, and fire pathogens would flourish further. It is also stated: 'For insufficiency of form, warm with qi; for insufficiency of essence, tonify with flavor. For exhaustion, apply warmth; for damage, apply benefit.' The *Shi Ji* (Ten Categories) states: 'Tonification can remove weakness; ginseng and mutton are examples.' My predecessor also said: 'Ginseng can tonify qi deficiency; mutton can tonify blood deficiency.' For consumptive diseases, eating mutton is perfectly acceptable." The person sighed and said: "Jiegu's (Zhang Yuansu's) learning indeed has its origins."
[Liangge San] Treats accumulation of heat and irritability in adults and children, excessive thirst, facial heat, cracked lips, dry throat, swollen tongue, throat obstruction, red eyes, epistaxis, hard nodules on the neck and cheeks, mouth and tongue sores, delirium and madness, dryness and constipation of the intestines and stomach, urinary and fecal retention, restlessness during sleep, and all types of wind-heat congestion.
Qianqiao (Forsythiae Fructus, 4 liang) Poxiao (Natrii Sulfas, 2 liang) Chuan Dahuang (Rhei Radix et Rhizoma, 2 liang) Bohe (Menthae Haplocalycis Herba) Huangqin (Scutellariae Radix) Shanzhizi (Gardeniae Fructus) Gancao (Glycyrrhizae Radix et Rhizoma, prepared, 1 liang each)
Grind the above seven ingredients into powder. Take 3 qian per dose, with 1.5 sheng of water, 5-7 leaves of Zhuye (Bambusae Folium), and a little honey. Decoct until reduced to 0.7 parts, strain, and take warm after meals. For children, take 0.5 qian, adjusting according to age. Stop subsequent doses if diarrhea occurs.
[Longnao Jisu Wan] Treats stagnant heat in the chest and lung heat, cough with hemoptysis, epistaxis, metrorrhagia, lower bleeding, bloody stranguria, and vexatious heat due to deficiency consumption.
Chaihu (Bupleuri Radix, 2 liang, sliced, soaked overnight in nearly 0.5 sheng of boiling water with Mutong, then strained for juice, added to the paste later) Mutong (Akebiae Caulis, 2 liang, sliced, mixed with Chaihu juice) Ejiao (Asini Corii Colla) Puhuang (Typhae Pollen) Renshen (Ginseng Radix, 2 liang each) Maidong (Ophiopogonis Radix, 4 liang) Huangqi (Astragali Radix, 1 liang) Jisu Jingye (Elsholtziae Spica/Cleomeae Herba, 1 jin, i.e., Longnao Bohe/Garden Mint) Gancao (Glycyrrhizae Radix et Rhizoma, 1.5 liang) Sheng Gan Dihuang Mo (Rehmanniae Radix Preparata, 6 liang, added to paste later)
Grind all ingredients into fine powder. Use 2 jin of honey, boil briefly once or twice, then add Sheng Di Huang Mo, stirring constantly. Gradually add the strained Chaihu and Mutong juice, slowly simmer into a paste without burning. Mix with the remaining powders to form pills the size of pea seeds. Take 20 pills per dose with warm boiled water.
[Xixin San] Treats accumulation of heat and wind-heat congestion in the heart and lungs, attacking upward causing dizziness and headache, stiffness and tension in the shoulders and back, painful joints, bitter taste, cracked lips, sore and swollen throat, phlegm-saliva stagnation, thick nasal discharge and sputum, dark and scanty urination, and constipation.
Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 liang) Mahuang (Ephedrae Herba) Danggui (Angelicae Sinensis Radix) Jingjie (Schizonepetae Spica) Shaoyao (Paeoniae Radix) Gancao (Glycyrrhizae Radix et Rhizoma) Dahuang (Rhei Radix et Rhizoma, 6 liang each)
Grind the above ingredients into powder. Take 2 qian per dose, with 1 sheng of water, adding a little fresh ginger and Bohe. Decoct until reduced to 0.7 parts, strain, and take warm.